MONDAY, Oct. 2, 2023 (HealthDay News) — Young Black patients with type 1 diabetes have clinically relevant higher average hemoglobin A1c (HbA1c) at any given level of mean blood glucose level than White patients, according to a study published online Sept. 12 in the Journal of Diabetes Science and Technology.
Nicholas J. Christakis, from Louisiana State University Health Sciences Center in New Orleans, and colleagues examined the relationship of HbA1c with glucose data from continuous glucose monitoring (CGM) in a young biracial population. The analysis included 33 Black and 85 White healthy youth with type 1 diabetes (age 14.7 years ± 4.8 years).
The researchers found that Black patients had higher unadjusted levels of HbA1c, mean blood glucose, glucose management index, and hemoglobin glycation index than White patients. Black participants also had lower percent glucose time in range and percent sensor use. Average HbA1c levels were higher in Black patients versus White patients (8.3 versus 7.7 percent) when adjusting for mean blood glucose, age, gender, and insulin delivery method and accounting for a race by percent sensor use interaction effect. When time in range was substituted for mean blood glucose, higher HbA1c persisted in Black patients. The 95th percentile for the hemoglobin glycation index was 0.47 in White patients, while 52 percent of Black patients had a hemoglobin glycation index ≥0.5. Both groups had similar time below range.
“We found that HbA1c overestimates mean blood glucose levels in African-American patients with diabetes,” Stuart Chalew, M.D., also from Louisiana State, said in a statement. “This can lead to increased occurrence of hypoglycemia in African-American patients if HbA1c is primarily used to guide insulin management of diabetes.”
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